목적 : 고도근시 환자에서 ICL 삽입술의 효능과 안정성, 결과 예측성 및 합병증 연구를 통해 중장기적 임상효과를 알아보고자 하였다. 대상과 방법 : 평균구면렌즈 대응치가 -11.91D (-6D~-23D)인 고도근시 환자로 ICL 수술 후 최소 6개월 이상 추적관찰이 가능하였던 97명 176안을 대상으로 후향적으로 조사하였다. 결과 : 술 후 1주 후 평균 구면렌즈 대응치는 -0.54D, 술 후 5년에 -0.55D로 굴절률의 안정성을 보였다. 술 후 6개월에서 1년 사이에 최대교정시력이 같거나 증가된 경우가 92.3%, 최종적인 교정시력이 0.5이상인 경우가 97%였으며, 남은 근시가 ±1D이하와 ±0.5D이하가 각각 91.3%와 86.4%로 높은 예측성을 보였다. 수술 후 합병증으로 불빛번짐 및 눈부심이 가장 많았고, 일시적인 고안압, 유의한 각막내피세포수 감소 등이 있었으며 3안에서 삽입된 ICL의 위치이상으로 재수술을 시행하였다. 수술 후 백내장은 7안(3.9%)에서 발생하였으며 나이가 많을 수록, Vaulting이 낮을 수록 유의한 발생률을 보였다. 결론 : 고도근시의 수술적 교정에 있어 ICL 삽입술은 단기적인 결과에서뿐만 아니라 5년간의 중장기적 임상결과에서도 예측성과 안정성이 높은 효과적인 수술이라 사료된다.

Purpose: We have investigated the long term effect, stability, predictability and complication of ICL implantation to treat high myopia. Methods: We investigated retrospectively in 176 eyes of 97 patients with spherical equivalent -11.91D (-6D~-23D) that were followed up for at least 6 months after ICL implantation. Results: Mean spherical equivalent was maintained stable as -0.54D at 1 week post-operatively, and at -0.55D for 5years. There was high effect and predictability, with 92.3% of the eyes exhibiting a greater than or equal to best corrected visual acuity (BCVA), 83% of eyes having a post-operative uncorrected visual acuity (UCVA) of 0.5 or better, 91.3% having a post-operative refraction of -1.0D~+1.0D, and 86.4% having a post-operative refraction of -0.5D~+0.5D. The most common complications were glare and halos. With a temporary increase in IOP, significant endothelial cell loss was observed. Repositioning for a dislocated ICL was done in 3 eyes. Post-operative cataracts were found in 7 eyes (3.9%), which was a significant increase in incidence, but not surprising, as the patients were older and had lower Vaulting values. Conclusions: ICL implantation to treat high myopia was an effective surgery with good predictability and stability, and effective in both short term and long term follow-up periods.

Purpose: We have investigated the long term effect, stability, predictability and complication of ICL implantation to treat high myopia. Methods: We investigated retrospectively in 176 eyes of 97 patients with spherical equivalent -11.91D (-6D~-23D) that were followed up for at least 6 months after ICL implantation. Results: Mean spherical equivalent was maintained stable as -0.54D at 1 week post-operatively, and at -0.55D for 5years. There was high effect and predictability, with 92.3% of the eyes exhibiting a greater than or equal to best corrected visual acuity (BCVA), 83% of eyes having a post-operative uncorrected visual acuity (UCVA) of 0.5 or better, 91.3% having a post-operative refraction of -1.0D~+1.0D, and 86.4% having a post-operative refraction of -0.5D~+0.5D. The most common complications were glare and halos. With a temporary increase in IOP, significant endothelial cell loss was observed. Repositioning for a dislocated ICL was done in 3 eyes. Post-operative cataracts were found in 7 eyes (3.9%), which was a significant increase in incidence, but not surprising, as the patients were older and had lower Vaulting values. Conclusions: ICL implantation to treat high myopia was an effective surgery with good predictability and stability, and effective in both short term and long term follow-up periods.

High myopia, ICL implantation, Long term follow up